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Published on: November 17, 2023
Ethnic and Geographic Variation in Prostate Cancer Presentation in Suriname
Henry A Wielzen1, Noah J Sandel2, Anand Ramsoekh1
1Department of Urology, Academic Hospital Paramaribo, Paramaribo, Suriname.
Purpose:
Suriname's ethnically diverse population lacks recent national pathology-based data on prostate cancer presentation. The aim of this study was to characterize clinicopathologic presentation patterns among histologically confirmed prostate adenocarcinoma patient cases in Suriname, with emphasis on ethnic and geographic variation in prostate-specific antigen (PSA) level and International Society of Urological Pathology (ISUP) grade group.
Methods:
We retrospectively analyzed 570 histologically confirmed prostate adenocarcinoma patient cases from the National Pathology Database of Suriname (2018-2023). Data on age, ethnicity, PSA level, ISUP grade group, and district of residence (remote versus nonremote) were extracted. Unadjusted comparisons were performed using nonparametric and chi-square tests, and multivariable logistic regression was used to identify factors independently associated with high-grade disease (ISUP grade groups 4-5).
Results:
Among 570 patients (median age, 69 years; IQR, 63-75), 40.9% had high-grade disease, and the overall median PSA was 21.0 ng/mL (IQR, 12.0-47.4). Although median PSA did not differ between African- and Asian-ancestry groups (21.0 v 20.3 ng/mL; P = .72), intragroup heterogeneity was observed: Maroon patients had numerically higher PSA levels than Creole patients (32.8 v 19.3 ng/mL; adjusted P = .228). In multivariable logistic regression (n = 331), Javanese ethnicity was independently associated with high-grade disease compared with Creole ethnicity (adjusted odds ratio, 3.31 [95% CI, 1.31 to 8.39]; P = .012). Patients from remote districts showed numerically higher PSA levels and a greater proportion of high-grade disease, although these differences were not statistically significant.
Conclusion:
This national pathology-based study found a high proportion of high-grade disease among histologically confirmed prostate cancer patients cases in Suriname and observed ethnic and geographic variation in disease presentation. These findings are hypothesis generating and support further prospective studies on diagnostic access and presentation patterns across population subgroups and geographic regions.
